Healthcare Provider Details

I. General information

NPI: 1083225858
Provider Name (Legal Business Name): ELIZABETH MARY ESKER COTA/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2020
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 MOE RD
CLIFTON PARK NY
12065-3821
US

IV. Provider business mailing address

1 HARLAU DR
SCOTIA NY
12302-4001
US

V. Phone/Fax

Practice location:
  • Phone: 518-280-4294
  • Fax: 518-280-4297
Mailing address:
  • Phone: 518-952-5960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number029598
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: